Physical therapy (functional capacity test)
Facility: Grisell Memorial Hospital
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $77
- Cash Discount Price: $84
- vs. Medicare Baseline: 2.28x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $33.73 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 228% of the Medicare baseline (a markup of 128%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $50 | 148% |
| UnitedHealthcare | $66 - $89 | 196% |
| Medicaid / KanCare | $89 | 264% |
| Humana | $89 | 264% |
Consumer Guidance & Cost Commentary
For the Physical therapy (functional capacity test) service at Grisell Memorial Hospital in Ransom, KS, the cash price of $84.00 is notably lower than the facility's median negotiated rate of $89.00 and the gross charge of $89.00. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds this amount, as the cash price avoids potential deductibles and copays. It is important to note that commercial payers like UnitedHealthcare and Blue Cross Blue Shield have negotiated rates ranging from $50 to $89, which can vary significantly by plan, so verifying your specific allowed amount before scheduling is essential to avoid unexpected costs.
When evaluating the cost against federal benchmarks, the Medicare amount for this service is $33.73, which serves as the objective baseline for determining fair pricing. The facility's cash rate of $84.00 represents a significant markup over the Medicare benchmark, illustrating how commercial rates often exceed the true cost of care delivery. To maximize savings, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees. Additionally, since over 80% of hospital bills contain errors, requesting a detailed, itemized statement before paying ensures that no unbundled codes or services not rendered are included in the final charge.